Provider Demographics
NPI:1003095324
Name:PERSONAL TOUCH REHAB AND FITNESS
Entity Type:Organization
Organization Name:PERSONAL TOUCH REHAB AND FITNESS
Other - Org Name:AMERICAN/DUTCH PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:BRODSKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-635-5575
Mailing Address - Street 1:3538 ORIOLE DR
Mailing Address - Street 2:
Mailing Address - City:HUNTINGDON VALLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19006-3412
Mailing Address - Country:US
Mailing Address - Phone:215-635-5575
Mailing Address - Fax:215-635-5456
Practice Address - Street 1:150 JAMES WAY
Practice Address - Street 2:
Practice Address - City:SOUTHAMPTON
Practice Address - State:PA
Practice Address - Zip Code:18966-3818
Practice Address - Country:US
Practice Address - Phone:215-635-5575
Practice Address - Fax:215-635-5456
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-02
Last Update Date:2021-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT0155152251N0400X, 305S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251N0400XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistNeurologyGroup - Single Specialty
No305S00000XManaged Care OrganizationsPoint of ServiceGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA078730OtherPTAN
PA1019816960001Medicaid
PA078730OtherMEDICARE GROUP
PA1019816960001Medicaid